Your initial payment will occur on 09/15/2019.
Your future annual billing will occur on the 15th of September or within 3 days thereafter.
Date of Customer Authorization: 09/15/2019

Your initial payment will occur on 09/15/2019.
Your future monthly / quarterly billing will occur on the 15th of September or within 3 days thereafter.
Date of Customer Authorization: 09/15/2019

Form AFHS Enroll - 1123TDD

DISCLAIMER: Please note that this advertised plan is not a health insurance policy. It provides discounts at certain health care providers for dental services. The advertised plan member is obligated to pay for all the health care services since the afvertised plan does not make payments directly to the providers of the dental services. You will however receive a discount from those health care providers who have contracted with the discount plan organization. The corporate name (Affordable Family Health Services, Inc.) and the locations of this licensed discount medical plan organisation are the administrators of this advertised discount plan. AFHS does not guarantee the quality of the services or products offered by individual providers. Please contact AFHS if you have dental Plan, Vision, Hearing, Lab, Prescriptions or Chiropractic questions.

Terms and Conditions

Renewal Conditions: By joining a plan, you are authorizing True Dental Discounts to bill your credit card or checking account for the plan you have selected. This charge shall remain in force until you notify True Dental Discounts of request to cancel. By joining, you indicate you have read the terms and conditions of the plan. This plan will automatically renew at the end of your membership term on an annual, quarterly, or monthly basis, and your credit card or bank account will be automatically charged or drafted for the appropriate amount.

Termination Conditions: True Dental Discounts reserves the right to terminate plan members from its plan for any reason, including non-payment.

Cancellation Conditions: You have the right to cancel within the first 30 days after receipt of membership materials and receive a full refund, less the processing fee, if applicable. If for any reason during this time period you are dissatisfied with the plan and wish to cancel and obtain a refund, you must submit a written cancellation request. True Dental Discounts will accept and cancel plan memberships at any time during the membership period and will cease collecting membership fees in a reasonable amount of time, but no later than 30 days after receiving a cancellation notice. Please send a cancellation letter and a request for refund with your name and member number to True Dental Discounts at 159 Parliament Loop, Lake Mary, FL 32746 or fax to: 888-888-8520. You may also submit cancellation by email: members@truedentaldiscounts.com.

Description of Services: Please see the enclosed materials for a specific description of the programs that you have purchased.

Complaint Procedure: If you would like to file a complaint or grievance regarding your plan membership, you must submit your grievance in writing to: True Dental Discounts, P.O. Box 950399, Lake Mary, FL 32746. You have the right to request an appeal if you are dissatisfied with the complaint resolution. After completing the complaint resolution process and you remain dissatisfied, you may contact your state insurance department.